Update from cjw0918...

[cjw0918]

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I know some of you may know me as a long-time lurker/poster on here. Just wanted to let my SDN family know that I have been dx with stage IIIB Hodgkin Lymphoma, Nodular Sclerosing subtype. I have had four chemo txs (ABVD) and am scheduled for 12 txs, through Jan 2010. I transferred home to a TX program from the East coast this July, and it was a lucky thing. My family is 3 hrs away now, and I live with my fiance. I am doing ok, depsite some really atrocious hair and feeling ptetty tired. Still planning on taking boards May/Jun 2010. Luckily my program has been super supportive. I'm a PGY-5 having already done a cyto f/s, and I am now completing my last year of AP/CP. I am schduled to do SP f/s next year here, but we'll have to see how everything goes with treatment. Just wanted to let all my pathologist friends know not to worry so much about professional success and finding the perfect job- the belief that you have SO much control over this is somewhat of an illusion anyway. Crap can always happen. Just do your best, work hard, try to believe it will all be ok. Because it will...

 

[Arctic Char]

words to live by. thank you for the message. keep up the optimism, and best wishes for your future.

 

[yaah]

Good luck, all the best in your fight - did you look at your own slides?

 

[cjw0918]

I had had a horrible cough for a couple of months, a few night sweats, low-grade fevers, and had overall just not been feeling well. I had been to a PMD who thought I had bad seasonal allergies w/ an associated infection and put me on antibiotics and allergy meds. I secretly thought I had Hodgkin's and had been feeling around around for LNs, and then I scratched my neck one day in conference and felt a deep, firm 1.5-2 cm supraclavicular LN. I walked right up to cytopath and asked for a STAT FNA telling them I thought I had Hodgkin's. They looked at me like I was crazy/paranoid, but did the FNA anyway. I looked at it with the attending and it was worrisome definitely. I had it taken out 3 days later and looked at it with hemepath. No one said a word. Talk about tension in the room! They said "We'll stain it," but I already knew what it was in my heart. The LN had no normal architecture, a syncitium-like area of R-S cells and lacunar cells, necrosis, and a polymorphous inflammatory backgound with lots of eosinophils. The fibrous bands were not well-developed. It is a very weird experience to see your own malignant tissue under the scope wih your colleagues. The stains came out perfectly for Classical Hodgkin Lymphoma, EBV negative. I got staged the next week, got a port placed, and started chemo the next week. I'm still working, and my attendings are pretty flexible if I'm not feeling well. All things considered I guess I am doing ok, just praying to God I get into remission (75% chance) and don't relapse. My chance of relapse over the next 3 years is 1/3, and for me that's just enough to drive me insane. I'll have a CT every 3 months for check-up. Wish me luck!

 

[dermpathdoc]

Hey good luck on your treatment and recovery!! we will keep you in our prayers.

 

[pathstudent]

Out of curiosity. Why do they do eBv on every Hodgkin case. Does it affect treatment or prognosis? Is that better or worse that you are ebv negative.

I had had a horrible cough for a couple of months, a few night sweats, low-grade fevers, and had overall just not been feeling well. I had been to a PMD who thought I had bad seasonal allergies w/ an associated infection and put me on antibiotics and allergy meds. I secretly thought I had Hodgkin's and had been feeling around around for LNs, and then I scratched my neck one day in conference and felt a deep, firm 1.5-2 cm supraclavicular LN. I walked right up to cytopath and asked for a STAT FNA telling them I thought I had Hodgkin's. They looked at me like I was crazy/paranoid, but did the FNA anyway. I looked at it with the attending and it was worrisome definitely. I had it taken out 3 days later and looked at it with hemepath. No one said a word. Talk about tension in the room! They said "We'll stain it," but I already knew what it was in my heart. The LN had no normal architecture, a syncitium-like area of R-S cells and lacunar cells, necrosis, and a polymorphous inflammatory backgound with lots of eosinophils. The fibrous bands were not well-developed. It is a very weird experience to see your own malignant tissue under the scope wih your colleagues. The stains came out perfectly for Classical Hodgkin Lymphoma, EBV negative. I got staged the next week, got a port placed, and started chemo the next week. I'm still working, and my attendings are pretty flexible if I'm not feeling well. All things considered I guess I am doing ok, just praying to God I get into remission (75% chance) and don't relapse. My chance of relapse over the next 3 years is 1/3, and for me that's just enough to drive me insane. I'll have a CT every 3 months for check-up. Wish me luck!

 

[medicomel]

cjw0918, i'm just an M4 applying to path residencies, but i want to wish you the very best in your recovery and continued success in your resident education.

 

[sarephina]

Oh, my. Thank you very much for sharing your experience and insights. Best wishes for your health and future. You'll be in my thoughts.

Kick butt!!!
- MS4

 

[DrBloodmoney]

Hey cjw, we met briefly at your previous program when both of us were at the VA. You are a super-nice person and I'm keeping my fingers crossed for your recovery and best wishes for your future!

 

[Isa2010]

My best wishes. Get well soon and stay strong. Blessings.👍

 

[pathologic]

Medical training is a very selfish exercise and we all too often put our career development before family and friends. We also can neglect ourselves in our personal development. I struggle to keep things in perspective and you sharing your situation is a great help. I can only speak for myself but I know I need to work more on my personal develompent. Putting my wellbeing before my CV. That is what I heard in your story and I thank you.

 

[106174]

medical training is a very selfish exercise and we all too often put our career development before family and friends. We also can neglect ourselves in our personal development. I struggle to keep things in perspective and you sharing your situation is a great help. I can only speak for myself but i know i need to work more on my personal develompent. Putting my wellbeing before my cv. That is what i heard in your story and i thank you.

amen!

 

[pathstudent]

So again i ask. Does the fact that your chl is ebv negative mean anything versus if it was ebv positive. On my lymphoma rotations i Noticed they order ebv on all hodgkin cases but I could never ascertain if it meant anything. On time when I asked my attending why we order it he said it was because we are an academic medical center and we offer a higher level of care. But that didn't really answer my question.

I had had a horrible cough for a couple of months, a few night sweats, low-grade fevers, and had overall just not been feeling well. I had been to a PMD who thought I had bad seasonal allergies w/ an associated infection and put me on antibiotics and allergy meds. I secretly thought I had Hodgkin's and had been feeling around around for LNs, and then I scratched my neck one day in conference and felt a deep, firm 1.5-2 cm supraclavicular LN. I walked right up to cytopath and asked for a STAT FNA telling them I thought I had Hodgkin's. They looked at me like I was crazy/paranoid, but did the FNA anyway. I looked at it with the attending and it was worrisome definitely. I had it taken out 3 days later and looked at it with hemepath. No one said a word. Talk about tension in the room! They said "We'll stain it," but I already knew what it was in my heart. The LN had no normal architecture, a syncitium-like area of R-S cells and lacunar cells, necrosis, and a polymorphous inflammatory backgound with lots of eosinophils. The fibrous bands were not well-developed. It is a very weird experience to see your own malignant tissue under the scope wih your colleagues. The stains came out perfectly for Classical Hodgkin Lymphoma, EBV negative. I got staged the next week, got a port placed, and started chemo the next week. I'm still working, and my attendings are pretty flexible if I'm not feeling well. All things considered I guess I am doing ok, just praying to God I get into remission (75% chance) and don't relapse. My chance of relapse over the next 3 years is 1/3, and for me that's just enough to drive me insane. I'll have a CT every 3 months for check-up. Wish me luck!

 

[medicomel]

http://cebp.aacrjournals.org/content/10/6/705.abstract

So again i ask. Does the fact that your chl is ebv negative mean anything versus if it was ebv positive. On my lymphoma rotations i Noticed they order ebv on all hodgkin cases but I could never ascertain if it meant anything. On time when I asked my attending why we order it he said it was because we are an academic medical center and we offer a higher level of care. But that didn't really answer my question.

http://cebp.aacrjournals.org/content/10/6/705.abstract

this took me .09 seconds to google. perhaps it's to document possible susceptibility from past EBV infections.

 

[pathstudent]

Sorry for asking. Good luck.

 

[NurseGollam]

Hi cjw, I remember reading your posts from a while back before I officially joined SDN. Wishing you the best of luck with treatment and (impending!) remission and recovery! It's wonderful that your program is so supportive of you. You will definitely be in my thoughts.

 

[mcfaddens]

But that doesn't answer my question. Does it matter in terms of treatment and prognosis? Who gives a crap about susceptibility from past infections. I mean, no ****, if you haven't had EBV your CHL can't have EBV. What piece of **** paper that is.

I can understand that pathstudent is a fool and does not understand many things in life but I hope that a moderator in the pathology forum can stop this person from posting, especially on certain topics. Yes, pathstudent may have not have violated TOS but changing the subject of this thread and making the situation of this thread a pseudo-academic conversation is so cold and is just immoral. PLEASE!!!!!! remove this kind of trash from our forum.

cjw0918,

I hope that you get well, I cannot imagine the kind of thoughts that run thru your mind, how much courage it takes and the hardship that you are encountering now. I wish you the best. Do take care of yourself and keep us updated here on the forum. Our prayers are with you.

 

[poutsara]

keep up your spirits and courage!! i wish you a speedy recovery 🙂

 

[Psychopathology]

Thank you for posting your experiences and for offering the mature, heart-felt thoughts that accompany them. I think I speak for everybody in wishing you good fortune and as quick and strong a recovery as imaginable.

 

[LADoc00]

I think I remember returning some PMs from you long ago...

Good luck. Always trust your instincts.

God Bless,
Ladoc and crew